1. Field of the Invention
The present invention relates generally to the field of surgical instruments and more specifically relates to a manually adjustable and disposable dermal curette.
2. Description of the Related Art
This invention relates generally to medical devices for removing slough and devitalized tissue from a wound surface and edges, scraping skin lesions, and more particularly to an improved disposable dermal curette which can respond to the changes in blade diameter required to debride a wound thoroughly.
A dermal curette is a device used by medical practitioners for scraping and debriding devitalized tissue, biofilm, and slough from chronic wounds; as well as growths, such as skin cancers, warts, actinic keratosis and seborrheic keratosis, from the surface of the skin. Generally, such devices are simple in construction, with a handle and a working element having a sharpened edge, which is used to scrape the surface of the wound or skin and remove the targeted tissue or debris. The working element is commonly a circular or ring-like configuration providing a curved or circular sharpened edge as the working surface of the curette.
There are generally three basic types of dermal curettes: the Fox Curette, the Piffard curette, and the eye curette. The Fox curette is a device having a flat handle, usually metallic, with a generally cylindrical arm extending from the handle, also metallic, terminating in a working element having an oval or rounded-loop cutting edge. The Piffard Curette has a large metal handle tapering inwardly from the bottom of the handle, with a generally cylindrical metallic arm extending from the handle and terminating in a working element having an oval or rounded-loop cutting edge. The Piffard Curette is further provided with grooves or ribbed surfaces extending lengthwise along the handle of the curette. The eye curette is similar in design to the Fox Curette, but has a working element, which is dish-like rather than looped-shaped, resulting in a working edge with a scooping action. The eye curette also has grooves or ribbed surfaces, which extend around the width of the handle. Variations of the dermal curettes described above are available and are identified and marketed as the Buck, Skeele, or Heath curettes. These curettes, as well as the ones described above, are made to be reused multiple times, that is, designed and manufactured far repeated use after sterilization and, if necessary, resharpening.
Dermal, curettes of such designs have been, and are currently being, used by physicians and mid-level providers in medical procedures for the removal of devitalized tissue, slough, biofilm and debris in chronic wounds, as well as lesions and unhealthy growths from the surface of the skin of a patient. Generally, the removal of slough and biofilm is done without anesthesia. However, in some procedures, the physician anesthetizes the area, removes the lesion or greater amounts of tissue with a scraping action utilizing a dermal curette and then cauterizes or electrode-siccates the area scraped if hemostasis is not achieved through compression. Sometimes the procedure is reversed in part and, after anesthetizing the area, the lesion is desiccated and then scraped using a curette. Ideally, all of the slough, biofilm, devitalized tissue, lesions or unhealthy tissues or growths are removed in the scraping procedure with minimal destruction of the remaining healthy tissues. A body of clinical research has shown that a thorough and effectively defended wound is key to a fast and quality recovery.
As with many medical procedures, the effectiveness of such scraping procedures depends upon two interrelated factors, namely, the skill of the physician or mid-level provider and the design of the tool used. Abnormalities of the skin, such as slough, biofilm, debris, and devitalized tissue in a chronic wound; as well as cancers, warts, actinic keratosis and seborrheic keratosis, differ to the touch from healthy tissues. Therefore, the experienced provider relies on the sense of touch during the scraping procedure and “feels’ the difference between healthy and unhealthy tissues. With the proper tools, the provider can use their sense of touch, to judge the depth of scraping necessary to remove only the targeted and unhealthy tissues, leaving the healthy tissues relatively unharmed.
Sharp debridement uses scalpels and curettes. Due to the complex structure of a chronic wound and the medical goal of achieving a thorough debridement, a typical debridement will require multiple sizes of curettes. Many procedures involve multiple wounds and new curettes are used for each wound. For practitioners, needing to switch back, and forth between multiple curettes for a wound is slow, cumbersome, and as a result leads to imprecise, ineffective debridements. For hospitals, multiple curette sizes represents unnecessary added costs, biohazardaus waste, and storage.
To accomplish this meticulous work in detail, a practitioner uses a variety of sizes. Based on feedback from one clinician, the max hoop size needed is 8 mm and the minimum hoop size is 2 mm. The range of sizes offered by a leading manufacturer of dermal curettes is 1 mm to 8 mm, with some only ranging 2 mm-7 mm.
Ideally, an adjustable curette should provide an ergonomic handle and a digitally-actuable means for selectively increasing and decreasing a diameter size of a blade formed into an adjustable loop for curetting, and, yet would operate reliably and be manufactured at a modest expense. The tool should posses a means to adjust, the size of the blade with the same hand that is holding the tool, in order to avoid disrupting the procedure. Furthermore, the tool should allow the practitioner to easily lock the size of the curette at a desired size and unlock it to change sizes so that, the cutting tool can be used fixedly without the need for the practitioner to monitor the adjuster.
In view of the sensory-dependent nature of such procedures, the design of the tool used is of critical importance. The curette must have a working element which is sharp enough to cut rather than pull and distort the tissue. Reusable curettes, like those described above, dull over time and do not hold, a sharp edge very well. Thus, a curette which provides a working element of consistent sharpness, which the disposable curette of the present invention provides because of its one-time use, is needed.
It is therefore an object of the present invention to provide a single instrument that can adjust and accommodate various tool head sizes without the need to unnecessarily switch out tools during a procedure.
It is another object of the present invention to provide an instrument that can quickly and easily modulate to accommodate the needs for a particular procedure or procedure.
It is also an object of the present invention, to provide an instrument that can quickly and easily be locked at a desired, cutting head size and unlocked at a desired cutting head size to allow for safe and consistent use of the cutting head.
It is yet another object of the present invention to provide a single curette tool that can be used for a variety of procedures by adjusting the cutting head size to meet the needs of a particular user and/or procedure.
It is a yet further object of the present invention to provide a disposable one-time use curette that can be brought to a procedure and modified for a particular instance or procedure.